ANEMIA :Zebeta
Posted by Surgery on Jul 13, 2008
The usual definition of anemia is a hematocrit value lower than two standard deviations below the mean for age and sex. Because the primary function of the red cell is to transport oxygen from the pulmonary bed to other tissues for release, anemia may impair oxygen delivery.
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Tissue oxygenation depends on the hematocrit, the oxygen affinity of hemoglobin, and the cardiorespiratory status of the patient. The only absolute indications for rapid correction of anemia by red cell transfusion are to restore tissue oxygenation and to expand blood volume after acute loss. Unfortunately, little information exists about the level of hematocrit necessary for adequate delivery of oxygen to the tissues. Observations on changes in coronary sinus oxygen saturation in dogs with varying degrees of acutely induced anemia (2) and the surgical experience among Jamaican patients with sickle cell disease (3) suggest that otherwise healthy young adults can tolerate short-term anemia with a hematocrit value between 20% and 25% without adverse outcome. In many pediatric centers, the sicker patients, particularly those with cardiorespiratory dysfunction, undergo transfusion to maintain the hematocrit closer to normal and maximize tissue oxygenation.
Tags: Blood, NEWS SURGERY, ZebetaPediatric Anesthesia, Pain Management, and Procedural Sedation : Vasodilan
Posted by Surgery on Jul 11, 2008
Each year, millions of children undergo surgical and medical procedures that require anesthesia or deep sedation. In many countries (including the United States), the majority of pediatric anesthetics are administered outside specialized pediatric hospitals, and many procedures are performed by surgeons who do not limit their practice to pediatric surgery. Improved understanding of pediatric pathophysiology and pharmacology, increased survival of premature infants at earlier stages of gestation, and new developments in noninvasive monitoring are allowing more critically ill children to survive to benefit from the advances in surgical technique. Safer anesthetic drugs, dramatic changes in the management of the pediatric airway, and greater numbers of anesthesiologists better trained to administer anesthesia to infants and children have greatly improved the safety for both healthy and critically ill pediatric patients undergoing surgery. An overview of principles of pediatric anesthesia would be incomplete without discussion-related areas, including pediatric acute and chronic pain management, and procedural sedation.
Blood - NORMAL HEMATOPOIESIS : Plendil
Posted by Surgery on Jul 11, 2008
Hematopoiesis in the human embryo and fetus can be divided into three overlapping phases: mesoblastic, hepatic, and myeloid (1). The earliest cells of erythroid lineage have been detected at day 14 of gestation within the blood islands of the yolk sac. By day 35, erythropoiesis occurs in the liver, and granulopoiesis and thrombocytopoiesis follow. Until 6 months gestation, the liver is the major site of hematopoiesis. The myeloid phase starts in the fourth month, when hematopoiesis, including monocyte and lymphocyte production, begins in the bone marrow. The bone marrow becomes the major site of hematopoiesis. Through early childhood, most of the bone marrow space is occupied by red (hematopoietically active) marrow. With age, the distal marrow spaces slowly fill with fat.
Tags: Blood, Infection, Plendil
Greetings, I the practising surgeon from Serbia. Call me Ivan Govak. In the works I use works
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